MEDICARE: CAITLIN BARNEY NEUBERGER MT-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225A00000X	Music Therapist	10613

General Provider Information

NPI Number	:	1275078479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAITLIN BARNEY NEUBERGER MT-BC

Provider Business Mailing Address
First Line	:	2548 E 150 S
Second Line	:
City	:	LAYTON
State	:	UT
Zip	:	84040-7400
Country	:	US
Telephone Number	:	801-920-8786
Fax Number	:

Provider Business Practice Location Address
First Line	:	122 WINDSOR AVE
Second Line	:
City	:	MERIDEN
State	:	CT
Zip	:	06451-2900
Country	:	US
Telephone Number	:	860-518-5557
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/23/2016
Last Update Date	:	12/23/2016

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